08030013 (2) CITY OF CUPERTINO 4
BUILDING DIVISION PERMIT tCC1EliTRACTC7R TNk'l1RMATIOt
PERMITNO.
BUILDLJp QOORgS
FOE SAN JOSE ROOF MAX 08030013
ANER''S7N7AMME:lJ PERMITISSUEDATE
HSU TSO—YEE AND WELLING 1352 CHIPLAY DR 03/04/2008
NE: SANITARY NO. CONTROL NO,
(408) 929-7663
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
loo LICENSED CONTRACTOR'S DECLARATION Job Description
hereby air,,.that 1 am licensed under pmv(siov of Chapter 9(m urn.ing
with Sseri.n70(10)af 0ivitlon3afthc Buaznw and Pr.fruiuv Code.and mylkenmu RE—RF T/0 SHK, INSTL 30LB FLT,CLS A 32SQ, INSTL OSB
rn in full fame endefyec
I�Z License Clsss C- I.icBRD
%n amar Sa►n -_Jai- -
ARCHITECTSDECLARAT1oN SAN JOSE ROOF MAX RENEWED BUS LIC 3/4/8
6 1 understand my plans shall he used a public=coast
1a ,
�Gt; Licensed Professional
3 OWNER-BUILDER DECLARATION
p
f i E I hereby rearm that 1 am exempt from dm Canuactar's License law for the
:O o following reason.(Section 706 1.5,Business and Professions Cade:My city or county
$ which acquires a permit in constrocL almm improve,demolish,or repair any structure
Z y prior m its issuance.also requires me applicant rot such permit a Ble aligned sonement
that he is licensed pursuant to the provisiavofthe Conacwr'sLicense Law(ChaNm9 Sq.Ft.Floor Area Valuation
3 $ (commencing with Section]0D0)ofDivision 3oftheBusiness And Professions Code)or $16500
..
that he is exempt therefrom and the Weis for the Mailed exampdm.Any vialafian of
Section 7031.5 by any applicant for a pemdt subjects the applicant to a civil posse ty ofely Number 'Occupancy Type
Act mom man five handmd dollars(3500). 3 5 9 2 5 0 2 0!
1,a owner arms property,or my employcm with wages As their sole compensation,
will d.thework.anl Nestacmm is aatimmoded or offered rorsale(Sm.] .Businue Required Inspections
And Professions Cade:The Contractor's License law does not apply u an owner e ns of q p
property who builds or improves thereon,and who does auc h work Mmself or through his
awn employees,provided that such improvements art not inmnddA naff xod(orsale.If.
however,Ne building or improvement 0 sold within oro year of completion.meOwner.
builder will have Ne burden of pmviag dot be did oat build.r improve for purpose of
sale.).
❑1,as Owner of the property,am exclusively contracting with licensed cenmcmrs At
...swot Ne project(Sec.7010,Business and Pmfesaon Code:)The Conuacma'a U-
cove law does not apply an an owns of property who builds or imp ons thereon.and.
who contracts for such projects with a eontracor(s)tica sed Pursuant to the Convactafa
License Law.
❑IAmeaemptunderSe, ,BRPCfa,du& son
nee Date
WORKERS COMPENSATION DECLARATION
1 hereby afrum under penalty of perjury ass of Ne following declarations:
❑Iham and will Seem.37M
of Code,
part. fa Campers- -
workfas provided far mi Section 3]00 of the labor Code,for,the per(omtance Of the
work far which this permit is issu.d.
❑1 have and will maintain WorkcYs Compensation Insurance,as required by Section
3700 of the Labor Cod.,for the perf.rman..of the werlr for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number am:
�z -
carrier.STAre Fo4cit Poliry N..:�''
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thlesection need not be completed if the permit Is foram hundred dollars($100)
or less.)
1 certify Nal in the performance of to work for which this permit I.tssucd.I shall.1
employ any person in any manner so as to become subject to m,workers'Compevadm
Laws of California.Data
Applicant
NOTICE TO APPLICANT:IL after making Nu CertiOmm of Enreplion:you should
Immune subject m to Worker's Compensation provisions of Ne labor Code,you muss
.J 0 forthwith comply with such paoviei.v ar this Permit shall be m
deeedvo
reked. .._.
'Z^' CONSTRUCTION LENDING AGENCY
[+� I hereby anion that them is a construction lending agency for the performance of
ai ti
the work fur which this permit is issued(Sec.3097,Civ.C.)
Q Lender's Name
rr7 z Undeh Address
V Q 1 certify that 1 have mad this application end sou Net the above information is
F correm I agree to comply with all city and county Ordinances and sum laws relating to
�U building consruclam,and hembyamhmire represenulives of this City m emerupOo the
�^U ahove-mentioned pmpCrty for inspection Puritans.
0. (Wc)agree m save,indemnify and keep leu Ne City of Cupertino.gaunt
vF-s fA Iiabiliue;jWgmcnu.cmumdexpenscawhichm yin any way accmc agaivtsaid City ^�J
U Z in consequence of Ute gaantin6 of this pc It. \�
.. APPLI R N'DERSTANDS N IL OMPLY WITH ALL NON-POINT Issued by: Date
SO ONS.
-am, Re-roofs
Igo re.11APPlicanUCamrtttor Data
HAZARDOUS MA RIALS DISCLOSURE Type of Roof
Will Ne applicant or forum building acupantsuas rehandle haaadous material
As defined by the Cupertino Municipal Cade.Chapter 9.12,and the HVIN And Safety '
cele,Section 25532(.)] All roofs shall be inspected prior to any roofing material being installed.
❑Yu w Na
Will the applicant or fu ono building occupant um equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hummicus air comandmants a dcOned by the Bay Arta Air Quality Management all new materials for inspection.
DisWct7 �/
❑Yes f3'a
I have read m.h. m-'its srequi crosunderChepurfi95ofllmCalifor-
niaHcalN&Safely Cao,Sadmu25505.2553 d25SM.l undcastand NazifNc Wilding
does not nd h A moans, it rt m prommility m nodty the aaupant of Ne
to ao aatbe arm. a.f.C'nikbc.fa.ap&xq. Signature of Applicant Date
owner a mad..ea As.nt 4zData All roof coverings to be Class "B"or better
• CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35925020. 00
DATE ISSUED. . . . . . . : 03/04/2008
RECEIPT #. . . . . . . . . : BS000004073
REFERENCE ID # . . . : 08030013
SITE ADDRESS . . . . . : 7595 DE FOE DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HSU TSO-YEE AND WELLING
ADDRESS . . . . . . . . . . : 7595 DE FOE DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4348
RECEIVED FROM . . . . : VICTALIANO ARTACHE
CONTRACTOR . . . . . . . : VICTALIANO ARTACHE JR. LIC # 25318
COMPANY . . . . . . . . . . : SAN JOSE ROOF MAX
ADDRESS . . . . . . . . . . : 1352 CHIPLAY DR
CITY/STATE/ZIP . . . : SAN JOSE, CA 95122
TELEPHONE . . . . . . . . : (408) 929-7663
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 16, 500. 00 1 .70 0. 00 1.70 0. 00
1BUSLIC FLAT RATE 1. 00 110 . 00 0. 00 110.00 0. 00
1REROOFRES SQ FEET 32 . 00 416 . 00 0. 00 416.00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 527 .70 0. 00 527 .70 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 527 .70 #1761
---------------
TOTAL RECEIPT 527 .70
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
------- --------------------------- ------ ---------------------------
601 ROOF TEAR OFF -602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
605 FINAL REROOF
•
CITY OF CUPERTINO
ql! REROOF
•CUPERTINO PERMIT APPLICATION
APN # Date:
35q ` 0 � roo - -o
Building Address:
r7s 5 Ca -
Owner's Name: Phone #:
7�50 - Ce- S� n
Contractor: Phone #: loF-lV9-7e
Com= /L-(CIX Fax #:
Cupertino Business License #: ContractorLicense
Type of Roof Covering:
Existing: Proposed:
❑ Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles Asphalt Shingles
gr Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles
❑ Other(Specify) ❑ Other (Specify)
Number of existing coverings ❑ Provide I.C.B.O. Report #
❑ To be Removed ❑ Provide Mfgr. Installation Specs.
Job Description:
-Tsar_ W_.j0 ojcl Ska4a, :ZNsF 1 ( OSg goa('L�
Falf� S•�s�i/� Cv•+�� s�. '�5/es. crJ ,
Residential Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: ❑
Valuation
Soo
I Have Read Under nd a Will Comply with Cupertino's Tear-Off Policy:
rgnAthre
CITY OF CUPERTINO
REROOF
OCUPEI�TINO FEE SCHEDULE
Number of Fee ID Fee Description Fee Permit Type
Squares Group
1REROOFCOM Re-roof Commercial B 1COMMLROOF
1BSEISMIC0 Seismic Commercial B
3 1REROOFRES Re-roof Residential B 1SFDWLR00F
1BSEISMICRE Seismic Residential B
IREROOFMRES Re-roof Multi-Family B 1MFDWLROOF
1BSEISMICRE Seismic Residential B
i1BUSLIC Business License B
•
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to any roofing installation.
4. To receive a final sign off from the City, the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
• 5. If plywood is installed, a plywood nail inspection is required.
6. Any roofing which is applied without first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be performed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4 " per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name: q
Job Site Address: �-pr.
Roofing Company Name: d a ��S c
Applicant's Signature: Date: 3 y o p
• Greg Casteel
Building Official
Revised 11/2/04
Community Development
10300 Torre Avenue
F 1= Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
UPEkTINO
Building De artment
JOB ADDRESS: PERMIT # o o O O
—7,S;-?r P�e 1�r. VO
OWNER'S NAME: 5jan Tese Ma*4, PHONE #
GENERAL CONTRACTOR:CONTRACTOR: FAX #
I am not using any subcontractors:
signqKdre Date
Please check applicable subcontractors and complete the followinginformation:
65 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
r Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date